中国广州在新冠大流行后出现肺炎支原体感染爆发。
Mycoplasma pneumoniae infection outbreak in Guangzhou, China after COVID-19 pandemic.
机构信息
Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, Guangzhou, 510120, Guangdong, China.
出版信息
Virol J. 2024 Aug 11;21(1):183. doi: 10.1186/s12985-024-02458-z.
BACKGROUNDS
Mycoplasma pneumoniae (M. pneumoniae) is a common pathogen causing respiratory diseases in children. This study aimed to characterize epidemiological and disease severity shifts of M. pneumoniae: infections in Guangzhou, China during and after the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
Throat swab samples were obtained from 5405 hospitalized patients with symptoms of acute respiratory infections to detect M. pneumoniae. Differences in epidemiological and clinical characteristics of M. pneumoniae: infections were investigated during 2020-2022 and after COVID-19 pandemic (2023).
RESULTS
M. pneumoniae were detected in 849 (15.6%, 849/5405) patients. The highest annual positive rate was 29.4% (754/2570) in 2023, followed by 5.3% (72/1367) in 2022, 1.2% (12/1015) in 2021, and 2.0% (11/553) in 2020, with significantly increasing annual prevalence from 2020 to 2023. M. pneumoniae incidence peaked between July and December post-COVID-19 pandemic in 2023, with the highest monthly positive rate (56.4%, 165/293). Clinical characteristics and outcomes of patients with M. pneumoniae did not vary between periods during and after COVID-19 pandemic except that patients with M. pneumoniae post-COVID-19 pandemic were more likely to develop fever. Patients with severe M. pneumoniae pneumonia (SMPP) were more likely to develop respiratory complications, myocardial damage, and gastrointestinal dysfunction than those with non-SMPP. Patients with SMPP had lower lymphocytes, CD3 T cells, CD4 T cells, CD8 T cells, B cells, and higher IL-4, IL-6, IL-10 levels than those with non-SMPP. Bronchoalveolar lavage fluid specimens from infected patients were obtained to identify macrolide resistance mutations. Macrolide-resistant M. pneumoniae (MRMP) proportion in 2023 was 91.1% (215/236).
CONCLUSION
Outbreaks of M. pneumoniae: occurred in Guangzhou, China in 2023 upon Non-pharmaceutical interventions easing. Despite the increasing incidence of M. pneumoniae, the disease severity remained similar during and after the COVID-19 pandemic.
背景
肺炎支原体（M. pneumoniae）是一种常见的病原体，可引起儿童呼吸道疾病。本研究旨在描述中国广州在 2019 年冠状病毒病（COVID-19）大流行期间和之后肺炎支原体感染的流行病学和疾病严重程度变化。
方法
从 5405 名有急性呼吸道感染症状的住院患者中采集咽拭子样本，以检测肺炎支原体。调查了 2020-2022 年和 COVID-19 大流行后（2023 年）肺炎支原体感染的流行病学和临床特征的差异。
结果
在 5405 名患者中检测到 849 名（15.6%，849/5405）肺炎支原体阳性。2023 年的年阳性率最高，为 29.4%（754/2570），其次是 2022 年的 5.3%（72/1367）、2021 年的 1.2%（12/1015）和 2020 年的 2.0%（11/553），呈逐年上升趋势。肺炎支原体的发病率在 COVID-19 大流行后 2023 年 7 月至 12 月达到高峰，最高月阳性率为 56.4%（165/293）。COVID-19 大流行期间和之后，患者的临床特征和结局没有差异，但 COVID-19 大流行后的肺炎支原体感染患者更有可能发热。重症肺炎支原体肺炎（SMPP）患者比非 SMPP 患者更易发生呼吸并发症、心肌损伤和胃肠功能障碍。SMPP 患者的淋巴细胞、CD3 T 细胞、CD4 T 细胞、CD8 T 细胞、B 细胞水平较低，IL-4、IL-6、IL-10 水平较高。从感染患者的支气管肺泡灌洗液标本中鉴定出大环内酯类药物耐药突变。2023 年大环内酯类耐药肺炎支原体（MRMP）的比例为 91.1%（215/236）。
结论
在中国广州，非药物干预措施放宽后，2023 年爆发了肺炎支原体感染。尽管肺炎支原体的发病率不断上升，但在 COVID-19 大流行期间和之后，疾病的严重程度仍保持相似。
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